Angioplastia primaria en nuestro medio. Análisis de los retrasos hasta la reperfusión, sus condicionantes y su implicación pronóstica

Introduccion y objetivos El mejor tratamiento para el IAM con elevacion del ST es la ICPP siempre que el tiempo puerta-balon sea  Metodos Hemos recogido de manera prospectiva los tiempos, los datos clinicos y angiograficos y el seguimiento a 1 y 12 meses de los pacientes a los que se realizo una ICPP o de rescate en nuestro centro de enero de 2005 a octubre de 2007. Resultados Se realizaron 389 angioplastias, 361 primarias y 28 de rescate. La mediana del tiempo de isquemia fue 235 [percentiles 25-75, 170-335] min. La mediana del TPG fue 79 [53-104] min. El TPG fue menor cuando el servicio de transporte urgente aviso al cardiologo de guardia, quien puso en marcha la alerta de hemodinamica, con una diferencia de 30 [90-60] min (p   120 min se asocio a mayor mortalidad a 30 dias y a una clara tendencia a aumentarla en el analisis multivariable. Conclusiones El tiempo puerta-guia en nuestro medio se ajusta a las recomendaciones vigentes, con una clara reduccion cuando el servicio de transporte urgente avisa con antelacion. Su reduccion se relaciona con una tendencia a una menor mortalidad a 30 dias.

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